Finding 1100420 (2024-007)

Significant Deficiency Repeat Finding
Requirement
E
Questioned Costs
-
Year
2024
Accepted
2025-02-20

AI Summary

  • Core Issue: Inaccurate information entry in Medicaid eligibility files, leading to potential miscalculations of income and household size.
  • Impacted Requirements: Compliance with 42 CFR 435 and 2 CFR 200 regarding proper documentation and internal controls for eligibility determinations.
  • Recommended Follow-Up: Retrain staff on documentation standards, ensure all files include necessary verifications, and conduct internal reviews to improve record-keeping practices.

Finding Text

Granville County, North Carolina Schedule of Findings and Questioned Costs For the Year Ended June 30, 2024 Recommendation: Views of responsible officials and planned corrective actions: US Department of Health and Human Services Passed through the NC Department of Health and Human Services Program Name: Medicaid Assistance Program (Medicaid; Title XIX) AL # 93.778 Finding: 2024-007 Inaccurate Information Entry SIGNIFICANT DEFICENCY Eligibility Criteria: Condition: Questioned Cost: Context: Effect: Identification of a repeat finding: Cause: Section III - Federal Award Findings and Questioned Costs (Continued) There was no known affect to eligibility and there were no known questioned costs. Files should be reviewed internally to ensure proper documentation is in place for eligibility. Workers should be retrained on what files should contain and the importance of complete and accurate record keeping. We recommend that all files include online verifications, documented resources and income and those amounts agree to information in NC FAST. The results found or documentation made in case notes should clearly indicate what actions were performed and the results of those actions. In accordance with 42 CFR 435, documentation must be obtained as needed to determine if a recipient meets specific standards, and documentation must be maintained to support eligibility determinations. In accordance with 2 CFR 200, management should have an adequate system of internal controls procedures in place to ensure an applicant is properly determined or redetermined for benefits. There were 2 errors discovered during our procedures where income or household size was incorrectly calculated or inaccurate information was entered into the case file. This is a repeat finding from the immediate previous audit, 2023-005. The County agrees with the finding. See Corrective Action Plan in the following section. We examined 60 cases from of a total of 576,600 Medicaid claims from the Medicaid beneficiary report provided by NC Department of Health and Human Services to redetermine eligibility. These findings are being reported with the financial statement audit as it relates to Medicaid administrative cost compliance audit. For those certifications/re-certifications there was a chance that information was not properly documented and reconciled to NC FAST and a participant could have been approved for benefits for which they were not eligible. Ineffective record keeping and ineffective case review process, incomplete documentation, and incorrect application of rules for purposes of determining eligibility. 172Granville County, North Carolina Schedule of Findings and Questioned Costs For the Year Ended June 30, 2024 Recommendation: Views of responsible officials and planned corrective actions: Program Name: Medical Assistance Program (Medicaid; Title XIX) AL # 93.778 Section IV - State Award Findings and Questioned Costs The County agrees with the finding. See Corrective Action Plan in the following section. Section III - Federal Award Findings and Questioned Costs (Continued) SIGNIFICANT DEFICENCY: Finding 2024-005, 2024-006, and 2024-007 also apply to State requirements and State Awards. Files should be reviewed internally to ensure all required verifications have been completed and information requested from the applicant/beneficiary or through various systems have been included and necessary procedures are taken when determining eligibility. The results found or documentation made in case notes should clearly indicate what actions were performed and the results of those actions. 173

Categories

Eligibility Internal Control / Segregation of Duties

Other Findings in this Audit

  • 523976 2024-005
    Significant Deficiency
  • 523977 2024-006
    Significant Deficiency Repeat
  • 523978 2024-007
    Significant Deficiency Repeat
  • 1100418 2024-005
    Significant Deficiency
  • 1100419 2024-006
    Significant Deficiency Repeat

Programs in Audit

ALN Program Name Expenditures
93.778 Medical Assistance Program $2.09M
10.561 State Administrative Matching Grants for the Supplemental Nutrition Assistance Program $848,864
21.027 Coronavirus State and Local Fiscal Recovery Funds $612,180
93.558 Temporary Assistance for Needy Families $488,233
93.563 Child Support Services $480,225
93.658 Foster Care Title IV-E $305,044
93.667 Social Services Block Grant $288,038
93.044 Special Programs for the Aging, Title Iii, Part B, Grants for Supportive Services and Senior Centers $212,961
93.045 Special Programs for the Aging, Title Iii, Part C, Nutrition Services $163,268
93.596 Child Care Mandatory and Matching Funds of the Child Care and Development Fund $130,403
93.767 Children's Health Insurance Program $120,961
93.568 Low-Income Home Energy Assistance $95,848
20.513 Enhanced Mobility of Seniors and Individuals with Disabilities $93,227
21.032 Local Assistance and Tribal Consistency Fund $80,307
14.228 Community Development Block Grants/state's Program and Non-Entitlement Grants in Hawaii $74,793
16.922 Equitable Sharing Program $63,975
21.016 Equitable Sharing $46,636
97.042 Emergency Management Performance Grants $34,839
97.067 Homeland Security Grant Program $31,463
93.053 Nutrition Services Incentive Program $27,739
20.600 State and Community Highway Safety $20,801
93.779 Centers for Medicare and Medicaid Services (cms) Research, Demonstrations and Evaluations $19,509
93.645 Stephanie Tubbs Jones Child Welfare Services Program $15,382
93.556 Marylee Allen Promoting Safe and Stable Families Program $6,859
93.659 Adoption Assistance $6,588
93.052 National Family Caregiver Support, Title Iii, Part E $4,453
93.674 John H. Chafee Foster Care Program for Successful Transition to Adulthood $2,701
45.310 Grants to States $1,798